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1598043614
MI RA LEE
ROCKFORD, IL
NPI
1598043614
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL 125059252)
Enumeration Date
2011-07-22
Last Update Date
2011-07-22
Business Address
-- MI RA LEE MD
1221 E STATE ST
ROCKFORD, IL 61104-2231
Phone number: 815-972-1000
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Mailing Address
-- MI RA LEE MD
1221 E STATE ST
ROCKFORD, IL 61104-2231
Phone number: 815-972-1000
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